PR in Nursing Has Taken the Front Seat in Patient Care

Or, objects in the mirror are closer than they appear. Lately, seems as if image in nursing or even PR in nursing has taken the front seat in what makes great patient care. Does it, really? Can facilities create an image through PR that make a difference in how a patient is cared for? Or perhaps just the perception of care? Nurses Announcements Archive Article

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PR is big business in nursing. In order to have positive PR, a facility has to have a positive image. It is sometimes a difficult thing to be a well respected nurse due to what the nurse knows, as opposed to how politically correct, positive company image a nurse portrays.

Nursing has had a great deal of images throughout the years. At one time, nurses were respected with the title that they held by their cap and starched white dress, pristine, a uniform that commanded a certain presence. Compassionate, firm with kindness, and never ending wealth of hands on care are some thoughts that come to mind when one remembers that swish/swish of a nurse's dress as she walked down the hall. Never a prouder moment when they would "earn their cap".

When nursing changed a bit--and even men entered the nursing profession, there was a period of time that the nursing was loyalty. A nurse would be so very proud to be where they were. Facilities were thrilled if a nurse was on top of patient care, every patient was where they should be, and there was time and boundless energy to fluff and buff and do extras. They may be in freshly ironed scrubs (which in some facilities didn't come along until the late 70's! And even into the early 80's it was still all white scrubs) but every patient was up and clean and meds were carefully crushed in medium of choice, and there were breaks and charting time.....and patient load was maybe 3 or 4 patients per nurse. 5-7 on a really, really busy day if someone was out sick. You had DON's who would round and help with patients, as the DON's were long time nurses.

Now, nursing image is seen through a carefully planned communication process that is meant to anticipate and exceed what the patient believes they would like. Ratios far outweigh what any one nurse could possibly accomplish in a day, and any extras are a thing of the long, long past. However, a nurse now needs to know how to make a patient believe they have hit payday with what is akin to a private duty nurse who only has them for a patient.

And here lies the disconnect. Nurses who are used to actually creating a plan of care that can be reasonably accomplished--warts and all--(and most elderly people dislike taking that drug that makes em pee all day) are instead discussing how they want to "exceed expectations". And newer nurses are shocked to realize that "fluffing and buffing" even existed at all.

At the end of the day we are all wrinkled. Some more than others. Patients are no longer people. They are measurements by which someone else gets paid, and it is not the nurses.

Those who come to the conclusion that nursing is no more than customer service with some meds added in---oh, ya and that pesky "let's keep em alive then we will REALLY get dinged" become jaded. And overwhelmed. And wondering where that "swish, swish" went.

Specializes in ICU.

My facility's management is terrible. They are all "ladder-climbers" with little bedside experience. Even our education department people haven't touched a real, live patient in decades. Many of the policies are out-dated, because they don't know anything new. Thank goodness I am a seasoned nurse, because there wouldn't be anyone to ask if I had a problem. I remember the days when the DON had bedside skills, wore whites, and pitched in to help. Today, they wear street clothes (expensive suits) and high heels. I remember when a supervisor/coordinator, etc., was the "go to person" who had vast nursing knowledge. Today, all they have are "people skills," they can talk a good line, but have very poor nursing skills, if any. Of course this is everywhere; just my experience.

Specializes in Med nurse in med-surg., float, HH, and PDN.

Just recently the local hospital (a large one made of two formerly separate hospitals, now joined together as one) announced they would be cutting MILLIONS from their budget, meaning many MORE nursing job cuts. Who is going to be left to provide care? They already have shut down several floors. I imagine one day a hospital stay will be a do-it-yourself prospect, at this rate. It already has started in that direction.

I did private duty at the same hospital several years ago, and quite literally not. one. single. nurse. entered that room during my 8 hr. shift. I was disgusted!

My facility's management is terrible. They are all "ladder-climbers" with little bedside experience. Even our education department people haven't touched a real, live patient in decades. Many of the policies are out-dated, because they don't know anything new. Thank goodness I am a seasoned nurse, because there wouldn't be anyone to ask if I had a problem. I remember the days when the DON had bedside skills, wore whites, and pitched in to help. Today, they wear street clothes (expensive suits) and high heels. I remember when a supervisor/coordinator, etc., was the "go to person" who had vast nursing knowledge. Today, all they have are "people skills," they can talk a good line, but have very poor nursing skills, if any. Of course this is everywhere; just my experience.

This post reminded me of the saying, "the emperor is wearing no clothes."

Specializes in LTC, assisted living, med-surg, psych.

Do not even get me started on the "customer service" construct. It's one of several reasons why I left bedside nursing. I never needed to be told to be nice to the patients and families; it came naturally. Maybe it doesn't for everyone and they need scripting to behave properly, but it sure wasn't needed in my day.....which wasn't all that long ago! :yuck:

Specializes in ICU,ER,med-Surg,Geri,Correctional.

The best PR is word of mouth from the actual patients/customers. Them saying I was in that hospital and I seen somebody every hour and they had time to sit and talk with me. Will go a lot farther in PR then these scripted hello my name is_____. Want to improve the PR of the hospital? simple. Increase staff. Let nurses nurse,improve the nurse/patient ratio. BTW for the largest healthcare system in the South. Don't have your nurse on "Down Time" calling the customers at home and trying to squeeze the word"Excellent out of them"

Specializes in ICU,ER,med-Surg,Geri,Correctional.

BTW while my wife was making a salad she dropped a grape. Of course the little 8lb terrier gobbled it up. I was out of town. So wife had to take the terror to the Emergency Vet they induced vomiting, the grape returned whole, charcoal was given . Paid 130 dollars sent home and observed based on the discharge instructions. Next they called inquiring about her condition, then day following they called for another up-date. Being cynical I asked them what other questions, they needed to ask me? Nothing we are just calling because of our concern....No PR script just real concern. Oh yes I sent them a WOW! card.

Yes agreed! One of the worst things I was ever told was that I 'spend too much time with the patient'. If that means alleviating their fears, explaining their care and their meds, giving bed baths, and giving them hope, then yes, I am guilty.

This!!! Is one of the many, many reasons why I like nurses so much. Every time I was scared, had a question about meds or care, it was always the nurse who stepped up to the plate and would take the time to answer them. I remember one time I was feeling so down about something the doctor had told me earlier in the day, it was my nurse who took time I know she did NOT have to talk with me to make me feel better and did silly things to make me laugh. I kept telling her as we were talking I don't want to put you behind, she said don't worry about me I want you to feel better, talking with her did make me feel better. I will never forget most of my nurses and the time they took with me and I'm sure your patients feel the same. Thanks for taking the time to care. YOU ROCK!!:)

Specializes in NICU, PICU, Transport, L&D, Hospice.

People in America think very highly of our health care system, that is the victory of PR based health care. The people love it but the health outcomes actually suck. Murrica.

I think the lines get blurred between "elevating the profession of nursing" and "devaluing the bedside nurse." It's great that professional RN's are encouraged to obtain advanced degrees and national specialty certifications. It's fabulous that we are supported in quality improvement projects, evidenced based care practices, and governance. We precept, we become charge nurses, we attend conferences, we make poster presentations, we co-author research projects, get our name in a professional journal article.

The problem comes in when many-if not most- of the nurses who do these things (and do them well) are on the fast track up and out of the bedside. They climb the ladder, and the ladder leads away from patients. And why wouldn't they? Professional recognition, status, a corner office on the 10th floor, bumped up several tiers on the pay scale, and don't have to worry about getting GI bleed on your shoes or coming home with a back injury.

The theory where I work is that your pay level should be commensurate with your "sphere of influence" so to speak. If you are a bedside nurse, you only influence the patients you take care of. If you are a charge nurse or preceptor, your influence extends further to your entire unit. If you are a nurse manager or nurse educator, now your sphere of influence is even larger. An so forth. But I think this is seriously flawed.

A compassionate, passionate, skilled bedside nurse has a huge sphere of influence. Just ask her patients.

Specializes in Pediatrics, Emergency, Trauma.

I very recently has a patient tell me that she wasn't receiving good customer service; I explained to her I was a Registered Nurse who was there to give her excellent patient care- she didn't complain after that.

YES!! :up:

I always have maintained to state to pts that I am here to give excellent patient care-from CNA, LPN and RN.

I haven't lost a job yet in this business by NOT scripting and giving into pts whims; if anything I have been getting leadership positions, so after all those years of advocating in the face of customer service, I must be doing something right.

This needs to be an advertising campaign for this quote. :cheeky:

Keep bring it back to what we are truly in "business" for!! :yes:

Specializes in Med Tele, Gen Surgical.

I left my staff meeting just gobsmacked. Apparently at the main hospital campus they have purchased some PR new fangled "interface" called the "Skylight" system that creates messages on the patient's television screen at regular intervals, one of which is something to the effect of, "How is your pain level, do you need pain medication? If so, use your call light to alert your nursing team." WTHeck? Now THAT is the danger of PR driving nursing care. In an effort to drive HCAPS (spelling on the acronym is probably not correct) scores into the desired range on the subject of pain control, we have PR driving nursing assessment and intervention. Probably not long before they will create a key pad for the patient to enter their pain level number, the "assessment" is sent to the nurse pager/vocera/whatever, and then a task appears for the nurse to go push some narcs. SHeeeeeesh.

Specializes in NICU, PICU, Transport, L&D, Hospice.
I left my staff meeting just gobsmacked. Apparently at the main hospital campus they have purchased some PR new fangled "interface" called the "Skylight" system that creates messages on the patient's television screen at regular intervals, one of which is something to the effect of, "How is your pain level, do you need pain medication? If so, use your call light to alert your nursing team." WTHeck? Now THAT is the danger of PR driving nursing care. In an effort to drive HCAPS (spelling on the acronym is probably not correct) scores into the desired range on the subject of pain control, we have PR driving nursing assessment and intervention. Probably not long before they will create a key pad for the patient to enter their pain level number, the "assessment" is sent to the nurse pager/vocera/whatever, and then a task appears for the nurse to go push some narcs. SHeeeeeesh.

If that is all the hospital system wants they don't need RNs to accomplish that. What you are describing does not require a nursing assessment or level of care. Let the hospitals replace RNs with med techs and more technology to wow the public. We can all wonder while we watch health outcomes sink to new lows at the same time that hospital CEOs rake in more $$